| NPI | 1780636985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE BUCKHOLTZ WITHERELL Co Owner 419-842-0860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-11-02 |